Infusion Intake Specialist II (32836)

GI Alliance; Southlake (TX); On-site; USD 52,000 - 68,000; Full time

Job summary

GI Alliance is seeking an experienced Infusion Intake Specialist II to review infusion orders and verify patient benefits to secure payment for services.

You will determine buy & bill vs Specialty Pharmacy pathways, assist with foundation copay programs, and secure prior authorizations while coordinating with insurance and pharmacy partners. Experience in infusion intake is preferred.

Qualifications

• High School diploma or GED required; associate degree preferred.
• 3-5 years infusion intake experience is preferred.
• Prior infusion intake experience related to infusion needed.

Responsibilities

• Review physician orders for Infusion.
• Verify patient benefits independently and with manufacturer hub programs.
• Determine whether the practice can buy & bill or if medication needs to be obtained through a Specialty Pharmacy.
• Assist patient with foundation copay programs, if eligible for reimbursement.
• Obtain foundation copay card information once assistance approved.
• Obtain prior-authorization for infusion services from patient insurance by calling carrier or submitting forms.
• If Specialty Pharmacy utilized, submit proper paperwork and patient clinical information.
• Assist in claims payment follow-up involving denials related to authorization or insurance coverage.
• Communicate necessary patient financial information with appropriate office and billing personnel.
• Communicate with patient regarding deductibles, copays, coinsurance, and financial assistance coverage.
• Alert supervisor of roadblocks to timely verification, prior authorizations and payment of infusion claims.
• Provide quality service to patients.
• Abide by all federal, state, and payer requirements and regulations.
• Perform other duties as assigned.

Skills

Communication

Customer service

Bilingual (English/Spanish)

Medical terminology (CPT/ICD-10)

Education

High School Diploma or GED

Associate degree preferred

Tools

MS Word

MS Excel

Job description

GI Alliance is seeking an experienced Infusion Intake Specialist II.

Position purpose

Review and process infusion services and physician orders in a timely and accurate manner to obtain payment for infusion services.

Responsibilities/Duties/Functions/Tasks

• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Review physician order for Infusion.
• Verify patient benefits independently and with appropriate manufacturer hub programs
• *Determine whether practice can buy & bill or if medication needs to be obtained through a Specialty Pharmacy.
• *Assist patient with foundation copay programs, if eligible for reimbursement program
• Obtain foundation copay card information once assistance approved
• *Obtain prior-authorization for infusion services from patients insurance company by calling insurance carrier and/or submitting required forms and medical records via fax or online portal
• *If Specialty Pharmacy utilized, submit proper paperwork and patient clinical information
• *Assist in claims payment follow-up involving denials related to authorization or insurance coverage
• *Communicate necessary patient financial information with appropriate office and billing personnel in an efficient, timely and accurate manner
• Communicate with patient regarding deductibles, copays, co-insurance, and financial assistance coverage
• *Alert supervisor of any roadblocks to timely verification, prior authorizations and payment of infusion claims
• Provide quality service to patients
• Abide by all federal, state, and payer requirements and regulations
• Perform other duties as assigned

Qualifications

Education: High School Diploma or GED required; associates degree preferred.

Experience: 3 5 years of prior infusion intake experience is preferred. Prior intake experience related to infusion needed.

Requirements For Level II Status

• Intermediate experience (4+ years experience) and/or acting more independently.
• Takes on additional duties to assist the office.
• Strong and consistent performer.

Performance Requirements

• Excellent communication skills, both written and verbal.
• Excellent customer service skills are required.
• Proficient computer skills, including MS Office experience, particularly in MS Word and MS Excel.
• Ability to multi-task and work in a fast-paced environment.
• Detail-oriented.
• Strong understanding of healthcare plans.
• Ability to read and understand medical benefits.
• Ability to read and understand payer medical policies.
• Bilingual is a plus.
• Medical terminology (CPT, ICD 10) knowledge.
• Self-motivated with initiative.
• Strong sense of ethics.

GI Alliance is an Equal Opportunity Employer. We are committed to creating an inclusive, welcoming, and equitable work environment. Our company values and celebrates the diversity of our physicians, staff and patients. We firmly believe our service is greatly enriched by our diversity of thought, experience, perspective, culture, and background.

Please Note: All job offers are contingent on the successful completion of pre-employment criminal history check.

EEO/AA-M/F/disabled/protected veteran